Reagan, Bonnie

Reagan, Bonnie is an individual health care provider with primary practice located at 541 Ne 20Th Ave Suite210, Portland OR 97232-2862. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Reagan, Bonnie can be contacted via phone (503) 233-6940.

Contact Information

Primary practice address
541 Ne 20Th Ave Suite210 Portland OR 97232-2862
Phone: (503) 233-6940
Fax: (503) 236-2676
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 14470 Oregon

Profile Details

NPI number 1255306205
LBN Legal business name Reagan, Bonnie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255306205 NPPES
Washington Other 49531 WA DEPT. OF L&I
Washington MEDICAID 8154130 WA DEPT. OF L&I
Washington MEDICAID 162032 WA DEPT. OF L&I

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